This position performs patient billing processes, to include, but not limited to, billing and third-party payer filings, review of superbill or electronic equivalent, review and reconciliation of invoices for patient related ancillary services, etc.
Minimum Qualifications:
Education
High School Diploma or Equivalent.
Certification through American Health Information Management Association or its equivalent is preferred.
Experience
Two years experience in medical coding in a healthcare setting required. Demonstrated experience with electronic health records and practice management systems. Medical coding in a community health center setting preferred. Cultural competence in working with diverse populations.
Essential Functions:
- Report to work as scheduled, on time and prepared to start working. Remain at work for their entire work schedule.
- Enters patient fees and codes into practice management system.
- Runs and verifies Daily Close/End of Day reports.
- Processes patient third party billings.
- Verifies insurance eligibility, submits claims, follows up on denials and delinquent insurance accounts. Resubmits claims as necessary.
- Maintains patient accounts and billing files and scans billing documents into practice management system as appropriate.
- Assists with investigating, processing and resubmitting patient third party explanation of benefit statements.
- Determines and processes patient fee adjustments.
- Responds to questions concerning patient accounts.
- Monitors patient account receivables and identifies and refers delinquent accounts.
- Completes training requirements to become a Certified Application Counselor and identifies uninsured patients and assists with insurance enrollment.
- Remains current with standards of health care billing and coding practices.
- Complies with center’s policies and procedures.
- Operates specialized office equipment.
- Participates in continuous quality improvement activities.
- Other duties as assigned.
Knowledge, Skills and Abilities
General accounting skills.
Knowledge of CPT and ICD-10 codes and use of automated information management system software.
Technically proficient computer skills.
Thorough knowledge of common office equipment (copier, fax, printer, etc.).
Excellent oral and written communication skills.
Ability to organize and prioritize tasks.
Ability to work under pressure and meet deadlines.
Strong analytical, attention to detail and problem-solving skills.
Ability to work independently and as a team member.